首页 中华核医学与分子影像杂志 2024年44卷06期 放射性碘难治性分化型甲状腺癌诊治管理指南(2024版)
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放射性碘难治性分化型甲状腺癌诊治管理指南(2024版)
中国临床肿瘤学会核医学专家委员会 
中国临床肿瘤学会甲状腺癌专家委员会
中华医学会核医学分会
中国研究型医院学会甲状腺疾病专业委员会
中国医疗保健国际交流促进会甲状腺疾病学分会
中国抗癌协会甲状腺癌专业委员会
中国人口文化促进会甲状腺疾病防治专业委员会
作者及单位信息
·
DOI： 10.3760/cma.j.cn321828-20240125-00034
Management guidelines for radioactive iodine-refractory differentiated thyroid cancer (2024 edition)
Nuclear Medicine Expert Committee of Chinese Society of Clinical Oncology
Thyroid Cancer Expert Committee of Chinese Society of Clinical Oncology
Chinese Society of Nuclear Medicine
Thyroid Disease Professional Committee of Chinese Research Hospital Association
Thyroid Disease Branch of China International Exchange and Promotive Association for Medical and Health Care
Thyroid Oncology Committee of China Anti-Cancer Association
Thyroid Disease Prevention and Treatment Committee of China Population Culture Promotion Association
Lin Yansong
Wang Renfei
Huang Rui
Wen Qiang
Authors Info & Affiliations
Nuclear Medicine Expert Committee of Chinese Society of Clinical Oncology
Thyroid Cancer Expert Committee of Chinese Society of Clinical Oncology
Chinese Society of Nuclear Medicine
Thyroid Disease Professional Committee of Chinese Research Hospital Association
Thyroid Disease Branch of China International Exchange and Promotive Association for Medical and Health Care
Thyroid Oncology Committee of China Anti-Cancer Association
Thyroid Disease Prevention and Treatment Committee of China Population Culture Promotion Association
Lin Yansong
Wang Renfei
Huang Rui
Wen Qiang
·
DOI： 10.3760/cma.j.cn321828-20240125-00034
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摘要
部分放射性碘难治性(radioactive iodine-refractory, RAIR)分化型甲状腺癌(differentiated thyroid cancer, DTC)进展迅速、预后差，诊治不规范，一直是临床关注的焦点。自《碘难治性分化型甲状腺癌的诊治管理共识(2019年版)》 [1]刊出后，基于分子特征进行甲状腺癌精准诊疗的理念已逐步形成，多项临床试验结果展示了多种分子靶向药物治疗RAIR-DTC的有效性和安全性，多手段联合治疗策略正日益展示其应用前景。同时，RAIR-DTC的临床诊治也面临诸多新的困惑和挑战。为此，中国临床肿瘤学会(Chinese Society of Clinical Oncology, CSCO)核医学专家委员会等多个学会组织相关领域专家，在综合共识出台后涌现的研究证据基础上，形成了针对RAIR-DTC的诊治管理指南。
引用本文
中国临床肿瘤学会核医学专家委员会,中国临床肿瘤学会甲状腺癌专家委员会,中华医学会核医学分会,等. 放射性碘难治性分化型甲状腺癌诊治管理指南(2024版)[J]. 中华核医学与分子影像杂志,2024,44(06)：359-372.
DOI:10.3760/cma.j.cn321828-20240125-00034PERMISSIONS
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部分放射性碘难治性(radioactive iodine-refractory, RAIR)分化型甲状腺癌(differentiated thyroid cancer, DTC)进展迅速、预后差，诊治不规范，一直是临床关注的焦点。自《碘难治性分化型甲状腺癌的诊治管理共识(2019年版)》
[
1
]刊出后，基于分子特征进行甲状腺癌精准诊疗的理念已逐步形成，多项临床试验结果展示了多种分子靶向药物治疗RAIR-DTC的有效性和安全性，多手段联合治疗策略正日益展示其应用前景。同时，RAIR-DTC的临床诊治也面临诸多新的困惑和挑战。为此，中国临床肿瘤学会(Chinese Society of Clinical Oncology, CSCO)核医学专家委员会等多个学会组织相关领域专家，在综合共识出台后涌现的研究证据基础上，形成了针对RAIR-DTC的诊治管理指南。
本指南推荐条款的产生参照推荐评估、制定与评价的分级(grading of recommendations assessment, development and evaluations, GRADE)方法，给出推荐强度等级及证据质量分级(
表1
)。全文涉及RAIR-DTC的界定、分子机制、预测与判断、综合处置及随访管理4个方面，共计27个临床问题，形成42条推荐条款，以期进一步推动RAIR-DTC的精准诊断、综合评估及规范化临床处置。
| 评定分级 | 定义 |
|---|---|
| 证据分级 | |
| 高质量证据 | 进一步研究也不可能改变该评估结果的可信度 |
| 中等质量证据 | 进一步研究很可能影响该评估结果的可信度，且可能改变该评估结果 |
| 低质量证据 | 进一步研究极有可能影响该评估结果的可信度，且该评估结果很可能改变 |
| 推荐强度 | |
| 强 | 明确显示干预措施利大于弊或弊大于利 |
| 弱 | 利弊不确定或无论质量高低的证据均显示利弊相当 |
展开表格
GRADE证据质量分级标准及推荐强度
注：GRADE为推荐评估、制定与评价的分级
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备注信息
A
林岩松，Email:
mocdef.3ab618691gnosnaynil；
B
王任飞，Email:
mocdef.3ab61ne_nylsor；
C
黄蕤，Email:
nc.defudabe.ucsiur_gnauh；
D
温强，Email:
nc.defudabe.uljgnaiqnew
E
所有作者声明无利益冲突
F
中央高水平医院临床科研专项项目 (2022-PUMCH-B-072)
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